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Association of CBC-derived systemic inflammation markers with first-episode peritonitis in peritoneal dialysis
Fang Gao1, Lulu Fan1, Hongyu Xiang1
1Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China.
Background:
Peritoneal dialysis-associated peritonitis (PDAP) remains a major cause of technique failure in peritoneal dialysis (PD) patients. Novel complete blood count-derived inflammatory markers, including the systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and aggregate index of systemic inflammation (AISI), may provide accessible tools for early PDAP risk prediction.
Methods:
In this retrospective cohort study, 302 PD patients were stratified according to incident PDAP during follow-up. Restricted cubic splines assessed nonlinear associations. Multivariable logistic regression evaluated independent associations with first-episode PDAP. Receiver operating characteristic curves assessed predictive performance.
Results:
Baseline SII, SIRI, and AISI levels were significantly higher in the PDAP group than in the non-PDAP group (all p < 0.05). Higher Ln-SII (OR: 3.598; 95% CI: 2.204-5.872), Ln-SIRI (OR: 2.425; 95% CI: 1.584-3.714), and Ln-AISI (OR: 2.007; 95% CI: 1.403-2.871) were independently associated with increased PDAP risk (all p < 0.001). SII showed the highest discriminatory performance among the three markers, with an area under the curve of 0.689. A combined model incorporating SII, SIRI, and AISI achieved an AUC of 0.715.
Conclusion:
Higher SII, SIRI, and AISI levels were associated with an increased risk of first-episode PDAP. A combined model demonstrates promising predictive accuracy.
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